As traditional Chinese medicine (TCM) gains credibility in the West, the practice of this nearly 5,000-year-old medical system has been faced with major challenges in the country of its origin. In 2006, Zhang Gongyao, a professor of philosophy at Zhongnan University, collected 10,000 signatures calling for "the abolition of traditional Chinese medicine" on the grounds that it was not scientifically based.

The move spurred a great deal of debate throughout China. While most supporters and practitioners of TCM dismissed Zhang's petition as "absurd", Fang Zhouzi, an academic known for his opposition to "pseudoscience", supported Zhang. Fang called TCM medical theory outdated, and said that China should focus on controlling and inspecting TCM herbs.

The debate was put to rest in October 2006, when China's Ministry of Health came out strongly against the petition to abolish TCM, saying it showed "ignorance of China's history".

Nevertheless, Chinese TCM doctors and experts agree that there have been major challenges to the development of the Chinese traditional medical system in recent years. Only one-fifth of patients now turn to TCM. One-third of patients use a combination of Western medicine and TCM treatments.

China has just 270,000 TCM doctors today, compared to 800,000 in the early 20th century, and 500,000 in 1949 at the founding of New China. Of the 85,705 medical institutions in China, only 3,009 were listed as TCM institutes in 2006, a decrease of nearly 800 from 2002.

Meanwhile, more and more TCM hospitals use Western medical tools and medicines for diagnosis and treatment, and rely less on TCM practices, such as pulse-taking and treatment with herbal medicines.

A major cause of the decline is the present mode of educating TCM doctors. In the past, TCM practitioners learned through a long apprenticeship. In the past 30 years, however, TCM has adopted a system similar to Western medicine for training doctors: four years of medical school, followed by hospital internships.

Pessimists say that TCM practices will be lost after the older generation of traditionally trained doctors die off. But in fact, many young practitioners who finished school in the 1980s have recognized the challenges ahead, and have advocated practicing "pure TCM".

According to a recent Internet survey by sina.com, 74.37 percent of 55,690 Internet users "greatly support TCM" and 81.3 percent believe "TCM has its own advantages". But only 42.48 percent said they would visit a TCM doctor, leaving 57.52 percent who said they would prefer a Western medical doctor.